Abstract
We describe a case of a 38-year-old male who presented with acute onset of right-sided hemiplegia and aphasia, who was transferred for emergent percutaneous intervention. Angiography revealed a dissection with total occlusion of the left internal carotid artery (ICA) with propagation of thrombus in the distribution of the middle cerebral artery (MCA). Therapy was directed at the MCA and not the ICA. Intra-arterial thrombolysis was performed on the M1 and M2 branches of the left middle cerebral artery, resulting in almost complete resolution of symptoms during the angiography procedure. Heparin was continued postprocedure, and the patient was discharged home on warfarin and aspirin with minimal residual symptoms.
Copyright 1999 Wiley-Liss, Inc.
MeSH terms
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Adult
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Angiography, Digital Subtraction
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Brain Ischemia / diagnostic imaging
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Brain Ischemia / drug therapy*
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Brain Ischemia / etiology
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Carotid Artery, Internal, Dissection / complications*
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Carotid Artery, Internal, Dissection / diagnosis
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Carotid Artery, Internal, Dissection / drug therapy
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Cerebral Angiography
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Drug Therapy, Combination
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Fibrinolytic Agents / administration & dosage*
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Heparin / administration & dosage*
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Humans
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Infusions, Intra-Arterial
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Male
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Middle Cerebral Artery / diagnostic imaging
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Plasminogen Activators / administration & dosage*
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Thrombolytic Therapy / methods*
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Ultrasonography, Doppler, Duplex
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Urokinase-Type Plasminogen Activator / administration & dosage*
Substances
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Fibrinolytic Agents
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Heparin
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Plasminogen Activators
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Urokinase-Type Plasminogen Activator